Hernial truss.



No. 703,095. Patented June 24, I902. G. H. STEWART &. A. L. WISEMAN.

HERNIAL TRUSS.

(Application filed Mar. 14, 1902.)

(No Model.)

0 w 5 -gnu" V WIITHBSSES Inventors UNITED STATES PATENT OFFICE.

GEORGE H. STElVART AND ABRAHAM L. NISEMAN, OF TOPEKA, KANSAS.

HERNIAL TRUSS.

SPECIFICATION forming part of Letters Patent No. 703,095, dated June24:, 1902.

Application filed March 14, 1902. Serial No. 98,231. (No model.)

To all whom it may concern.-

Be it known that we, GEORGE H. STEWART and ABRAHAM L. WISEMAN, citizensof the United States of America, residing at Topeka, in the county ofShawnee and State of Kansas, have invented new and useful Improvementsin Hernial Trusses, of which the following is a specification.

Our-invention relates to hernial trusses, the

object being to produce a truss which is light, durable, effective, easyto wear, and simple in construction.

It relates particularly to the class of truss in which the pad isattached to a Wire comprising an arch fitting over the hip and having abody-strap to hold it in place, the strap being double or divided, onepart connected to the arch at about its summit and the other at its rearend. As heretofore constructed these two straps have passed around thebody nearly parallel, but coming gradually together, joining at somepoint in the front of the body of the patient, both straps having asubstantially horizontal orlateral pull. As thus constructed the straps,or at least the upper one, passes around the small of the back, causingpressure thereon, which is injurious to the kidneys. On this accountpatients have frequently suffered from kidney trouble.

One of the objects of our truss is to bring all the straps below thesmall of the back, while at the same time securing the pad and arch morefirmly in their positions and producing a truss which when once adjustedto a particular patient may be readily replaced by him. To accomplishthis by the devices more fully described hereinafter and shown in thedrawings accompanying and forming a part of this specification, in whichFigures 1 and 2 are respectively front and rear views of our trussapplied to the patient. Fig. 3 is a view of the outer or flattened sideof the pad, showing the method of attaching the arch-wire thereto. Fig.4: is a similar view of the pad, the arch-wire and stud being removed.Fig. 5 is a section of the pad through the line 50 y, Fig. 4. Fig. 6 isa side view of the pad. Fig. '7 is a side view of the U-bend of thearch-wire. Fig. 8 is a side view of the stud-screw e. Fig. 9 is onemethod of attaching the main body-strap to the arch-wire at its summit,and Fig. 13 is a side view of the hook and strap. Fig. 10 is a top viewshowing another method of said attachment by sewing. Fig. 11 is a Viewof the connection of the strap F to the main body-strap by means of thestud or button G, whichis shown in Fig. 12.

The pad A has the general form of a halfpear, the convex side beingpresented to the body of the patient, the larger end uppermost and theaxis of the pad resting at an approximate angle of forty-five degrees toa horizontal plane, it being understood, of course, that it lies overthe inguinal canal and may vary somewhat from that angle in differentpersons. In referring to the different parts of the pad, however, asinner side, upper end, 850., it will be understood that reference ismade to the pad as occupying substantially this position. Our paddiffers from others in two particularsfirst, in having its outer uppercorner cut away, giving the upper inner corner or end anabnormany-protruding effect, and, second, in having the recess a, whichhas the hole 0 inits bottom, and the groove (Z to take in, respectively,the U-bend, the inwardly-bent extreme end f of the wire, and the wirebeyond the U bcnd, hereinaftermore fully described. The pad is made byturning it from the rough piece intoa substantial pear shape, thencutting it in two'longitudinally, making one portion slightly largerthan the other portion, using the larger portion for the pad. The upperouter corner is then cut away, which gives the upperinner corner A anabnormally-protruding effect, so that said upperinner corner forms asort of plug for the hernia. The use of pads having the general shape ofa half-pear is not new with us; but the abnormally-protruding upperinner corner is new. It is the object of all good pads to close theinternal ring and nearly or quite the entire inguinal canal. Theaccomplishment of this object, of course, requires considerable nicetyof adjustment. With the old forms of pad the large end of the pad hasrested merely against the internal ring and the inguinal canal,while inour improved form the upper inner corner forms a plug which forces theparts into the internal ring, thus more effectively forming a perfectclosure for the hernia, while atthe same time giving the desiredpressure against It serves at least two purposes.

the entire or nearly the entire inguinal canal, and the cutting away ofthe upper outer corner of the pad serves to prevent the pad fromslipping upward and away from the hernia, as also to prevent the wearerfrom being pinched or chafed, a feature especially desir-,

able to persons having prominent abdomens.

The end of the arch-wire D, which is attached to the pad, has aU-bend,its extreme endf being bentinwardlyinto the pad. Theinwardly-bent extreme end f of the arch-wire constitutes a novel andimportant feature of our means for attaching the wire to the pad.

It gives rigidity to the attachment and prevents the otherwise exposedend of the wire from being caught in the clothing. The wire is heldfirmly in said recess a bya retaining-plate, which is formed by thelower flange of the stud-screw e, which is screwed into the pad betweenthe legs of the U-bend. The legs of the U-bend are just far enough apartto perm it the working therethrough of the shank of the stud-screw 6.Each leg thus has a bearing on each side, the bottom of the recess aforming one bearing, the side of the recess forming the second bearing,the shank of the stud-screw forming the third bearing, and the flange ofsaid stud forming the fourth hearing. We believe this means for theattachment of the wire to the pad to be more firm than any heretoforedevised. We do away with many of the complicated parts which haveheretofore been used. WVe simplify the parts, as it will be seen that weemploy simply the screw-stud e besides the pad and the arch-wire.Moreover, after the pad has been once adjusted to the patient he maydetach the pad from the arch-wire, if he so desires, and replaceit'himself without being required to refit or readjust it. There is nodanger of its getting out of adjustment. It can be seen that even thoughthe screw should work somewhat loose the pad cannot move away from theangle at which it has been adjusted unless the wire be entirely removedfrom the recess and groove.

The arch D is made, preferably, of springwire. It has a flexiblecovering B, which is made, preferabl y,of two strips of leather sowedtogether with the wire between them. This prevents the chafing of thewearer and gives an easy bearing against the hip of the patient. Thesummit O of the arch rests approximately at the crest of the ilium andthe rear end of the arch rests at the rear of the hip. E is the mainbody-strap, which is attached to the wire D or its covering 13 at thesummit C, preferably a little in the rear of the crest of the ilium.This attachment is made by sewing, as in Fig. 10, or by the hook H,attached to the arch, as in Figs. 9 and 13, whose tip H is adapted to bebent into the strap to prevent its getting loose. The end of the strap,of course, is perforated. At the rear end of the ,arch is the stud Z, towhich is attached the perforated lower end of the auxiliary strap F,whose upper end is attached to the main body-strap E at the back of thepatient bythe stud G. which is like an ordinary collar-button. istwofold-first, to pull the main body-strap, E downwardly, and, second,to hold the rear end of the arch in proper position by the correspondingupward pull. The object in pulling the main body-strap downward at theback is twofoldfirst, that it will not rest against but below the smallof the back, and, second, to give it a downward pull at its attachmentto the arch summit. The object in holding the rear end of the arch inposition by the corresponding upward pull is so that the rear end may beas far as possible toward the side of the patient, While still bearingagainst the body against the corresponding inward or rearward pressureof the pad. Of course if the rear end were permitted to slip too fararound on the side of the patient it would serve no practical purposewhatever, either as a bearing against the pressure of the spring againstthe pad or to keep the body-strap from slipping sidewise. By attachingthe main strap at the summit we are able to come closer to a verticalposition for the rear portion of the arch than has heretofore beenpossible, and we find that the forward portion of the arch swings, as ona hinge, on the rear portion-- that is, the rear portion has its bearingon and against the rear of the hip near the side, being held in placethereon by said two strapswhile the pull of the end of the main strapwhich is attached to the pad is in the general direction of the swing ofthe forward portion of the arch and draws the pad rearward and upwardagainst the hernia. The main bearing of the rear end B of the arch isagainst the hip. The auxiliary strap Fserves only to keep it it inposition thereonthatis, keeps it from sliding too far around on the sideof the patient, which is its normal tendency. The main horizontal pullupon the arch as a whole which offsets the pull of the main body-strapupon the pad is exerted by said strap E at the arch summit. Byconnecting the auxiliary strap to the main body-strap at the back italso serves the additional purpose, as heretofore explained, of drawingthe latter strap down below the small of the back. Now the purpose ofthe auxiliary strap being made clear, it will be understood that itoccupies a substantially vertical position,although it may vary greatlyfrom the actual perpendicular. In actual practice it is found to givebest results by making the connection at a point about one inch from thespine on the side on which the arch is located. It will also be seenthat the main body-strap by reason of its being thus drawn downwardlypasses around the opposite side of the body, resting against the side ofthe hip-bone somewhat lower down on the body than the summit of Theoffice of this auxiliary strap,

the arch, but still not so low but that it gives an upward pull againstthe pad. By reason of this low position upon the body and its bearingupon the pelvic bones it is free from disturbance by the bending of thebody.

The truss is fitted by bending the wire D to conform to the patient, thearch resting upon the hip, so that the internal ring is covered by theupper end of the pad, the pad nearly or quite covering the inguinalcanal. The main body-strap is then brought around and fastened to thestud e in the pad, the strap F being adjusted so there is but slighttension on it. The lengthening and shortening of this auxiliary strapdetermines the position of the arch upon the hip. The main body-strap Ebears nearly or quite all the horizontal or lateral pull upon the arch,the pull of the auxiliary strap being substantially vertical. There issubstantially no horizontal or lateral pull on the auxiliary strap. Thepad is drawn upwardly and inwardly against the hernia.

In all trusses it is expected that the truss shall be fitted to thepatient, in the first instance, by a person skilled in the art. Itfrequently happens, however, that the truss is removed by reason of thescrews or fastenings in the pad working loose or by other accident orfrom desire, and it is then a difficult matter for the patient toreplace the truss unless he be expert, and it has seemed im practicablewith the trusses of this kind heretofore used to instruct the patient sothat he himself can replace the truss in its proper position. He mayeasily be instructed, however, as to the location of the internal ring.Once known it is seldom forgotten. The patient can then quickly andsecurely replace our truss by placing the arch over the hip, with theupper end of the pad bearing inwardly and upwardly against the internalring, and then bringing the body-strap around and attaching it to thestud 2, so there is easy tension on both straps.

Having thus described our invention, what we claim as new, and desire tosecure by Letters Patent, is-

1. The combination with a pad and wire comprising the arch attachedthereto, of a main body-strap connecting the pad and approximately thesummit of the arch, and an auxiliary strap connecting the rear end ofthe arch and the main body-strap at the back.

2. The combination with a pad and wire comprising the arch attachedthereto, of a main body-strap connecting the pad and approximately thesummit of the arch, and a substantially vertical auxiliary strapconnecting the rear end of the arch and the main body-strap.

3. The combination with a pad having the general form of a half-pear andhaving its up per outer corner cut away as shown giving the upper innercorner an abnormally-protruding effect so as to form a plug for thehernia;

of awire comprising the arch attached to the pad; a main body-strapconnecting the pad and approximately the summit of the arch; and asubstantially vertical auxiliary strap connecting the rear end of thearch and the main body-strap.

4. The combination with a pad having the general form of a half-pear andhaving its upper outer corner cut away as shown giving the upper innercorner an abnormally-protruding efiect so as to form a plug for thehernia; of a wire comprising the arch attached to the pad; a mainbody-strap connecting the pad and approximately the summit of the arch;and an auxiliary strap connecting the rear end of the arch and the mainbody-strap at the back.

5. In a hernial truss the combination with a pad having the general formof a half-pear and having its upper outer corner cut away as showngiving the upper inner corner an ab normally-protruding efiect so as toform a plug for the hernia; a recess and a groove in the outer surfaceof said pad and a hole in the bot tom of the recess; a wire comprisingthe arch fitting in the groove, and having a U -bend fitting in therecess, the extreme end f of the wire being bent inwardly into the holein the bottom of the recess; a stud screw whose shank is screwed intothe pad between the legs of the U-bend and whose lower flange forms aretaining-plate for the U-bend; and means for holding the pad and archon the body.

6. In a hernial truss, the combination with a pad having a recess in itsouter surface, of a wire comprising the arch having a U-bend fitting inthe recess, the extreme end j of the wire being bent inwardly into thepad, and means for holding the U-bend in the recess.

7. In a truss the combination with a pad having a groove and recess inits outersurface; of a wire comprising the arch fitting in the grooveand having a U -bend fitting in the recess; a screw-stud whose shank isscrewed into the pad between the legs of the U-bend and whose lowerflange forms a retaining-plate to hold the U-bend in the recess; theextreme end f of the arch-wire being bent inwardly into the pad.

' 8. The combination with a pad having a groove and a recess in itsouter surface; of a wire comprising the arch fitting in the groove andhaving a U -bend fitting in the recess, the extreme end f of the Wirebeing bent inwardly into the pad, and means for holding the U- bend inthe recess; a stud on the pad; a main body-strap connecting the pad andapproximately the summit of the arch, and an auxiliary strap connectingthe rear end of the arch and the main body-strap at the back.

9. The combination with a pad having the general form of a half-pear andhaving its up per outer corner cut away as shown giving the upper innercorner an abnormally-protruding effect so as to form a plug for the ICChernia; a recess anda groove in the outer surface of said pad; a wirecomprising the arch fitting in the groove and having a U -bend fittingin the recess, the extreme end f of the wire being bent inwardly intothe pad; a studscrew whose shank is screwed into the pad between thelegs of said U-bend and whose lower flange forms a retaining-plate forthe U-bend; a main body-strap connecting the pad and approximately thesummit of the arch; and an auxiliary strap connecting the rear end ofthe arch and the main body-strap at the back; substantially asdescribed.

In testimony whereof we have afiixed our signatures in presence ofwitnesses.

GEORGE H. STEWART. ABRAHAM L. WISEMAN.

Witnesses to signature of George H. Stewart:

JOSEPH GRoLL, Z. T. FISHER.

Witnesses to signature of Abraham L. Wiseman CHAS. E. BALDWIN, M. L.ROWLAND.

